Abdominal Compartment Hypertension and Abdominal Compartment Syndrome

Abstract

Abdominal hypertension and compartment syndrome are frequent events following large-volume fluid resuscitation, complex ventral herniorrhaphy, pancreatitis, and other common disorders in the ICU. Early signs and symptoms heralding IAH and ACS lack sensitivity, and a high index of suspicion is needed to diagnose these problems early. Failure to recognize ACS, in particular, is associated with increased mortality related to multisystem organ failure. Whereas abdominal decompression remains the gold standard of treatment, other nonoperative treatment options, such as paracentesis and pharmacologic paralysis, can be used in selected instances. When a decompressive laparotomy is performed, timely closure of the abdominal wall is essential to minimize risk of development of an entero-atmospheric fistula and loss of domain ventral hernia.

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